Your pneumonia patient is hypotensive, tachycardic, and not responding to fluids… what did you miss? It could be sepsis-induced cardiomyopathy, a common under-recognized shock state you could see at the bedside.

In this episode, Dr. Mahmoud Ibrahim MD and host Sarah Lorenzini use a case study to highlight how nurses, intensivists and the ICU team can work together to recognize the signs of sepsis-induced cardiomyopathy early and give patients a better chance at recovery. You'll learn the diagnostic clues that your patient’s heart is in trouble, how to approach controversial treatments like sodium bicarb, and what has to happen before intubation in a dual shock state.

Topics discussed in this episode:

• What the initial bedside assessment says about the patient
• Treatment priorities for the  intensivist and nurse
• Signs that point to more than just sepsis
• Why fluids aren’t always the answer
• Blood pressure management: vasopressors and inotropes
• Pathophysiology of sepsis-induced cardiomyopathy
• How a sepsis-induced cardiomyopathy diagnosis changes treatment
• The vasopressin debate for sepsis-induced cardiomyopathy
• Clues your intervention isn’t working and what to do next
• How to prepare the patient for high-risk intubation
• What you need to know about administering sodium bicarb
• Why collaboration matters at every step for patient recovery

Connect with Dr. Ibrahim:

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Learn more about the different phenotypes in sepsis induced cardiomyopathy:

https://journal.chestnet.org/article/S0012-3692(25)05143-8/abstract

Mentioned in this episode:

Rapid Response Academy Winter 2026 Cohort

https://www.rapidresponseandrescue.com/rra